What is hepatitis A and B?

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The big hepatitis ABC

Hepatitis viruses cause liver inflammation and can also be transmitted during sex. But you can easily protect yourself from infections. Hepatitis is an important issue for s.a.m health – but the focus is on protection and not on regular testing. We therefore do not offer tests for hepatitis, but will inform you about protection options.

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What kind of hepatitis viruses are there?

There are a total of 5 hepatitis viruses that are not related to each other, but have one thing in common: they cause inflammation of the liver. They are named with letters: Hepatitis A, B, C, D and E.

s.a.m Health recommends vaccination against hepatitis B if you are sexually active and have several or changing sexual partners and were not vaccinated as a child It is often advisable to be vaccinated against hepatitis A at the same time with a combination vaccine.

What is hepatitis A?

Hepatitis A is rarely transmitted during sex, but there have been repeated outbreaks of hepatitis A in Europe in recent years among gay men and other men who have sex with men. Although the hepatitis A virus “only” causes an acute illness – the infection always heals itself – this acute illness in adults usually confines the patient to bed for weeks. The hepatitis A viruses are excreted with the feces, they are ingested with the mouth. Even the slightest traces are sufficient for infection, for example if a finger touches the anus during sex and then comes to the mouth.

You can also contract hepatitis A from undercooked vegetables or shellfish (especially in countries with poor hygiene conditions). In some regions, even tap water is not safe (which is also used for ice cubes, for example…). A vaccination against hepatitis A therefore not only offers protection during sex, but also when traveling.

In Germany, hepatitis A is rare, affecting around one in 100,000 people every year.

What is hepatitis B?

Hepatitis B is transmitted very easily during any kind of sex, the viruses are present in all bodily fluids. Another common transmission route is when people inject drugs or other substances and share syringes. Infections with hepatitis B can become chronic and over the course of decades can lead to unnoticed shrinkage and scarring of the liver (liver cirrhosis) and even liver cancer. Whether people with hepatitis B are infectious depends on the amount of virus in their blood.

Overall, hepatitis B is not rare, but fortunately it does not occur on a massive scale: Around 10 cases per 100,000 inhabitants are currently reported in Germany every year.

What are the symptoms of hepatitis B?

Most people do not experience any symptoms when they become infected with the hepatitis B virus. When symptoms occur, they usually include fatigue, nausea, upper abdominal discomfort or fever.

A yellowing of the eyes and skin (“jaundice”, medically: “icterus”), combined with dark urine and light-colored stools, is rather rare. Chronic hepatitis B is usually only manifested by a slight increase in liver values.

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Vaccination against hepatitis A and hepatitis B

You can’t really protect yourself against hepatitis A and B with condoms during sex. But the good news is that there is an effective vaccination. For people who have a higher risk during sex, the statutory health insurance covers the costs (for both vaccinations), in the case of hepatitis A also for travelers to regions with an increased risk. If the GP practice has doubts about this (which can sometimes happen), you can refer to the “vaccination guidelines” of the Federal Joint Committee (www.g-ba.de). The guideline specifies which vaccinations are covered by health insurance for which people.

The Standing Vaccination Commission at the Robert Koch Institute has recommended hepatitis B vaccination for infants since 1995. If you were born after 1995, you may already be vaccinated.

💡 By the way: if you are vaccinated against hepatitis B, you are also protected against hepatitis D! You can find out whether you have been vaccinated either in your vaccination record or at your GP’s surgery. Your blood will be tested for the corresponding antibodies.

However, you can also be vaccinated without a prior test. It is crucial for the success of the vaccination that you have received all the recommended doses.

As already mentioned, it is advisable to be vaccinated against hepatitis A at the same time with a combination vaccine.

This article was written by: Armin Schafberger – physician and health scientist, as well as former medical officer of the German AIDS service organization.

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